Urostomy: Changing Your Pouch

You’ve just had a urostomy. As part of your surgery, a small opening (stoma) was made on your belly (abdomen). Urine and mucus drain from the stoma into a disposable pouch. You’ll be shown how to change your pouch before you leave the hospital. How often you will need to change your pouch will depend on the type of pouch system you use. It can be anywhere from daily to up to 1 time week. Change it early in the morning, when your urine output is less. To change your pouch, follow the steps below.

How to change your pouch

To change your pouch, follow the steps below:

Step 1: Prepare the new pouch.

• Gather your supplies in the bathroom. Wash your hands with soap and clean, running water. Supplies include plastic bags, toilet tissue, paper towels or a soft washcloth, a clean cloth or towel, an extra skin barrier wipe (if desired), and a new pouch.

• If you don’t use a pouch with a precut skin barrier, size and cut the opening.

• Slowly peel the backing off the skin barrier. Set the skin barrier aside.

• Empty the used pouch before removing it. When you empty the pouch, sit on the toilet. Or stand in front of the toilet.

Step 2: Remove the used pouch.

• When removing the used pouch, sit on the toilet. Or stand in front of it.

• Carefully push the skin away from the skin barrier with one hand. Do this starting at the upper edge of the barrier. With the other hand, slowly peel the skin barrier off from top to bottom.

• Seal the used pouch in a plastic bag. Then throw it away in your regular trash.

Step 3: Clean around the stoma.

• Use toilet paper to wipe urine or mucus from the stoma and the skin around it.

• Clean the skin with warm water and a soft washcloth or paper towel. Wash right up to the edge of the stoma. You can also do this when you shower. Getting wet won't harm the stoma. But remember that urine will keep coming out.

• Pat the skin dry with a clean towel.

Step 4: Put on the new pouch.

• Use a folded paper towel or a piece of gauze to keep your stoma dry while you’re putting on the new pouch.

• Using 1 hand, pull the skin on your belly tight to smooth out any wrinkles. If you use a barrier wipe, use it on the skin around the stoma.

• Starting from the bottom of your stoma, apply the skin barrier. Put the palm of your hand over the barrier. Hold the barrier in place for 45 seconds. This molds it to your skin.

• If you use a 2-piece pouch, snap the pouch onto the skin barrier. Start at the bottom and work your fingers around the barrier to get a tight seal.

• Make sure the pouch drain is in the closed position. If the pouch has a drain cap, put it on.

• After you change the pouch, wash your hands.

When to call your healthcare provider

Call your ostomy nurse or other healthcare provider right away if:

• The skin around the stoma is red, weepy, bleeding, or broken.

• The skin around the stoma itches, burns, stings, or has white spots.

• The stoma swells, changes color, or bleeds without stopping.

• The stoma sinks below its normal level or below the skin.

• The stoma sticks up above the skin more than normal.